MEDICARE: ERIN WALSH PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	5911	AZ

General Provider Information

NPI Number	:	1396739611
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN WALSH PT

Provider Business Mailing Address
First Line	:	9419 N ARROYA VISTA DR E
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85028-4809
Country	:	US
Telephone Number	:	602-402-0178
Fax Number	:

Provider Business Practice Location Address
First Line	:	539 E GLENDALE AVE
Second Line	:	SUITE 5
City	:	PHOENIX
State	:	AZ
Zip	:	85020-4900
Country	:	US
Telephone Number	:	602-241-3145
Fax Number	:	602-241-3146

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2005
Last Update Date	:	07/08/2007

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Directions to “ ERIN WALSH PT” Practice Location

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